Local and Regional Anesthesia in Dental and Oral Surgery

Abstract

Local anesthesia is the standard of care for dental surgery. While effective at controlling pain, regional procedures in dentistry are associated with rare but unique complications. A variety of local anesthetics and nerve block approaches are used for dental procedures. Lidocaine represents the gold standard for dental local anesthesia. Local complications related to dental regional anesthesia include risk of needle breakage, paresthesia, transient facial paralysis, and self-inflicted injury of still-insensate soft tissues. Local anesthetic toxicity and allergic reaction represent potential systemic complications. New developments, including computer-controlled local anesthetic delivery systems, agents to reverse local anesthesia (e.g., phentolamine mesylate), and intranasal delivery of local anesthetic mist, may help to reduce complications going forward.